Informed Consent For Cataract Operation, And Implantation of an Intraocular Lens.

Introduction

This information is given to you so that you can make an informed decision about having cataract surgery. Take as much time as you wish to make your decision about signing this informed consent. You have the right to ask questions about any procedure before agreeing to have the operation.  Cataract surgery is indicated when vision is not adequate.y

You have been informed that you have cataract, you decision to proceed with surgery should be based on your visual needs and assessment of the risks of operation. 

Insertion of Intra Ocular Lens (IOL)

There are the three methods of restoring useful vision after the cataract removal. Insertion of an IOL after removal of the cataract is standard procedure but it may not be possible or you may for some reason prefer not to have an IOL inserted.

1. Intraocular Lenses
   This is a small artificial lens  permanently inserted into the eye after removal of the cataract.  The intraocular lens made from Silicone or a variety of plastic polymers contains an ultraviolet (UV) light absorbing material. Intraocular lenses have been implanted since 1949 and have proven clinically safe and effective. They give the best quality of vision after cataract removal. Conventional eyeglasses may be needed in addition to an intraocular lens to give you the best vision possible. Your doctor can provide information to help you decide which intraocular lens is right for you, should you choose this method of restoring useful vision after the cataract operation.

2. Spectacles (Glasses)
   If no implant has been inserted then special high power Cataract spectacles are required. These are much thicker and heavier than conventional glasses. Cataract spectacles magnify everything by about 12% causing problems with distortion, judgement and balance.

3. Contact Lens
   A hard or soft contact lens increases the apparent size of objects minimally. Handling of a contact lens is difficult for some individuals. Most lenses must be inserted and removed daily and not everyone can tolerate them. For near tasks, eyeglasses (not cataract spectacles) may be required in addition to contact lenses.

    

Consent for Operations

In giving my permission for a cataract extraction and for the possible implantation of an intraocular lens in my eye, I declare I understand the following information:

1. Cataract surgery, by itself, means the removal of the natural lens of the eye by a surgical technique. In order for an intraocular lens to be implanted in my eye, I understand I must first have cataract surgery performed.

2. If an intraocular lens is implanted, it is done as part of the operation. It is intended that the lens will be left in my eye permanently.

3. The results of surgery in my case cannot be guaranteed.

4. At the time of surgery, my doctor may decide not to implant an intraocular lens in my eye even though I may have given prior permission to do so.

5. There may be complications of surgery. As a result of the surgery it is possible that my vision could be made worse. In some cases complications may occur weeks, months, or even years later. Complications may include haemorrhage (bleeding), loss of corneal clarity, infection, detachment of the retina, glaucoma, and/or double vision. These and other complications may occur whether or not a lens is implanted and may result in poor vision, total loss of vision, or loss of the eye.

6. At some future time the lens implanted in my eye may have to be repositioned or removed surgically.

7. Complications of surgery in general: As with all types of surgery there is the possibility of other complications due to anaesthesia, drug reactions or other factors which may involve other parts of my body, including possibility of brain damage or even death. Since it is impossible to state every complication that may occur as a result of surgery, the list of complications in this form is incomplete.

The basic procedures of cataract surgery and the advantages and disadvantages, risks and possible complications of alternative treatments have been explained to me by the doctor. Although it is impossible for the doctor to inform me of every possible complication that may occur, the doctor has answered all my questions to my satisfaction. In signing this informed consent for cataract operation and/or implantation of an intraocular lens, I am stating I have read this Informed Consent (or it has been read to me) and I fully understand it and the possible risks, complications, and benefits that can result from the surgery.

Patient’s Signature ........................................................................................

Patient’s Name (printed) ........................................................................................

Age ...........................

Date ............................... Time ............................ Place ..............................

Witness’ Signature ........................................................................................

Doctor’s Signature ........................................................................................

As guardian, caretaker, next-of-kin, or other legal representative responsible for the patient whose name appears on the previous page on the appropriate patient signature line, I have read this informed consent and, to the limit of the patient’s understanding, I have discussed this informed consent and its terms with the patient.

Due to the patient’s inability to sign this informed consent, I agree of behalf of the patient to sign for the patient and bind him/her to the term of this informed consent.

Signature of Legal Representative ........................................................................................

Name of Legal Representative (printed) ........................................................................................

City ....................................... State ................................... Postcode .....................

Relationship to Patient ........................................................................................

Date ................................... Time ................................. Place ................................